The spino-pelvic ratio: a novel global sagittal parameter associated with clinical outcomes in adult spinal deformity patients

European spine journal

article

Wesley M. Durand¹  Alan H. Daniels²  David K. Hamilton³  Peter Passias⁴  Han Jo Kim⁵  Themistocles Protopsaltis⁴  Virginie LaFage⁵  Justin S. Smith⁶  Christopher Shaffrey⁷  Munish Gupta⁸  Michael P. Kelly⁸  Eric Klineberg⁹  Frank Schwab⁵  Doug Burton^1,10  Shay Bess^1,11  Christopher Ames^1,12  Robert Hart^1,13 

[1] Warren Alpert Medical School of Brown University;Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University;University of Pittsburgh Medical Center;Department of Orthopedics, NYU Langone Orthopedic Hospital;Hospital for Special Surgery;University of Virginia Health System;Duke University;Washington University;University of California-Davis;University of Kansas Hospital;Denver International Spine Center;University of California-San Francisco;Swedish Neuroscience Institute

关键词: Adult spinal deformity;    Sagittal alignment;    T1 pelvic angle;    Pelvic incidence;   

DOI  :  10.1007/s00586-020-06472-x

来源: Springer

【 摘 要 】

Analysis of interactions of spinal alignment metrics may uncover novel alignment parameters, similar to PI-LL. This study utilized a data-driven approach to hypothesis generation by testing all possible division interactions between spinal alignment parameters. This study was a retrospective cohort analysis. In total, 1439 patients with baseline ODI were included for hypothesis generation. In total, 666 patients had 2-year postoperative follow-up and were included for validation. All possible combinations of division interactions between baseline metrics were assessed with linear regression against baseline ODI. From 247 raw alignment metrics, 32,398 division interactions were considered in hypothesis generation. Conceptually, the TPA divided by PI is a measure of the relative alignment of the line connecting T1 to the femoral head and the line perpendicular to the sacral endplate. The mean TPA/PI was 0.41 at baseline and 0.30 at 2 years postoperatively. Higher TPA/PI was associated with worse baseline ODI (p  0.4). The R-squared for ODI against categorical TPA/PI alone (0.154) was directionally higher than that for each of the individual Schwab modifiers (SVA: 0.138, PI-LL 0.111, PT 0.057). This study utilized a data-driven approach for hypothesis generation and identified the spino-pelvic ratio (TPA divided by PI) as a promising measure of sagittal spinal alignment among ASD patients. Patients with SPR > 0.2 exhibited inferior ODI scores. III.

【 授权许可】

Unknown